NURSES' GUIDE TO TEACHING
DIABETES SELF-MANAGEMENT,
SECOND EDITION
2ND EDITION
• AUTHOR(S)RITA GIROUARD
MERTIG
TEST BANK
1) Insulin and glucose use
Reference: Ch. 1 — How Insulin Works
Question Stem:
A 24-year-old client with newly diagnosed type 1 diabetes asks
why insulin is necessary. The client says, “My blood sugar is
high, so why can’t my cells just use the glucose already in my
blood?” Which explanation by the nurse is best?
,Options:
A. “Insulin helps glucose move from the blood into body cells
for energy.”
B. “Insulin prevents the kidneys from filtering glucose into the
urine.”
C. “Insulin is needed only to prevent diabetic ketoacidosis.”
D. “Insulin replaces the body’s need for carbohydrate intake.”
Correct Answer: A
Rationale — Correct:
Insulin allows glucose to enter many body cells, especially
muscle and fat cells, where it can be used for energy. In type 1
diabetes, the pancreas makes little or no insulin, so glucose
stays in the bloodstream despite being available there.
Rationale — Incorrect:
B. Insulin does not directly stop renal glucose filtration; glucose
spills into urine when blood levels exceed the renal threshold.
C. Preventing DKA is important, but insulin has a broader role in
glucose utilization.
D. Carbohydrates remain a needed energy source; insulin does
not replace dietary intake.
Teaching Point:
Insulin moves glucose from blood into cells for energy.
Citation:
Mertig, R. G. (2019). Nurses' Guide to Teaching Diabetes Self-
Management (2nd ed.). Ch. 1.
,2) Insulin and fasting glucose
Reference: Ch. 1 — How Insulin Works
Question Stem:
A client with type 2 diabetes reports a fasting glucose of 168
mg/dL each morning despite eating “very little” at night. Which
explanation best helps the client understand the result?
Options:
A. “The liver may still release glucose overnight when insulin
action is inadequate.”
B. “The kidneys are making extra glucose while you sleep.”
C. “Nighttime fasting always causes glucose to fall below
normal.”
D. “Glucose only comes from food, so the reading must be
inaccurate.”
Correct Answer: A
Rationale — Correct:
When insulin is insufficient or ineffective, the liver can continue
releasing glucose through glycogen breakdown and
gluconeogenesis, raising fasting levels. This is a common issue in
diabetes and helps explain morning hyperglycemia.
Rationale — Incorrect:
B. Kidneys do not make glucose in the way described here.
C. Fasting does not necessarily lower glucose if hepatic glucose
output remains high.
, D. Glucose comes from food and from liver production; the
reading may still be accurate.
Teaching Point:
Fasting hyperglycemia can come from liver glucose release, not
just food.
Citation:
Mertig, R. G. (2019). Nurses' Guide to Teaching Diabetes Self-
Management (2nd ed.). Ch. 1.
3) Type 1 vs type 2 diabetes
Reference: Ch. 1 — Classification of Diabetes
Question Stem:
A 19-year-old client arrives in the clinic with a 2-week history of
polyuria, polydipsia, and an 8-lb weight loss. The client is thin
and has ketones in the urine. Which classification does the
nurse suspect first?
Options:
A. Type 1 diabetes
B. Type 2 diabetes
C. Prediabetes
D. Gestational diabetes
Correct Answer: A
Rationale — Correct:
Rapid onset, weight loss, and ketones suggest severe insulin
DIABETES SELF-MANAGEMENT,
SECOND EDITION
2ND EDITION
• AUTHOR(S)RITA GIROUARD
MERTIG
TEST BANK
1) Insulin and glucose use
Reference: Ch. 1 — How Insulin Works
Question Stem:
A 24-year-old client with newly diagnosed type 1 diabetes asks
why insulin is necessary. The client says, “My blood sugar is
high, so why can’t my cells just use the glucose already in my
blood?” Which explanation by the nurse is best?
,Options:
A. “Insulin helps glucose move from the blood into body cells
for energy.”
B. “Insulin prevents the kidneys from filtering glucose into the
urine.”
C. “Insulin is needed only to prevent diabetic ketoacidosis.”
D. “Insulin replaces the body’s need for carbohydrate intake.”
Correct Answer: A
Rationale — Correct:
Insulin allows glucose to enter many body cells, especially
muscle and fat cells, where it can be used for energy. In type 1
diabetes, the pancreas makes little or no insulin, so glucose
stays in the bloodstream despite being available there.
Rationale — Incorrect:
B. Insulin does not directly stop renal glucose filtration; glucose
spills into urine when blood levels exceed the renal threshold.
C. Preventing DKA is important, but insulin has a broader role in
glucose utilization.
D. Carbohydrates remain a needed energy source; insulin does
not replace dietary intake.
Teaching Point:
Insulin moves glucose from blood into cells for energy.
Citation:
Mertig, R. G. (2019). Nurses' Guide to Teaching Diabetes Self-
Management (2nd ed.). Ch. 1.
,2) Insulin and fasting glucose
Reference: Ch. 1 — How Insulin Works
Question Stem:
A client with type 2 diabetes reports a fasting glucose of 168
mg/dL each morning despite eating “very little” at night. Which
explanation best helps the client understand the result?
Options:
A. “The liver may still release glucose overnight when insulin
action is inadequate.”
B. “The kidneys are making extra glucose while you sleep.”
C. “Nighttime fasting always causes glucose to fall below
normal.”
D. “Glucose only comes from food, so the reading must be
inaccurate.”
Correct Answer: A
Rationale — Correct:
When insulin is insufficient or ineffective, the liver can continue
releasing glucose through glycogen breakdown and
gluconeogenesis, raising fasting levels. This is a common issue in
diabetes and helps explain morning hyperglycemia.
Rationale — Incorrect:
B. Kidneys do not make glucose in the way described here.
C. Fasting does not necessarily lower glucose if hepatic glucose
output remains high.
, D. Glucose comes from food and from liver production; the
reading may still be accurate.
Teaching Point:
Fasting hyperglycemia can come from liver glucose release, not
just food.
Citation:
Mertig, R. G. (2019). Nurses' Guide to Teaching Diabetes Self-
Management (2nd ed.). Ch. 1.
3) Type 1 vs type 2 diabetes
Reference: Ch. 1 — Classification of Diabetes
Question Stem:
A 19-year-old client arrives in the clinic with a 2-week history of
polyuria, polydipsia, and an 8-lb weight loss. The client is thin
and has ketones in the urine. Which classification does the
nurse suspect first?
Options:
A. Type 1 diabetes
B. Type 2 diabetes
C. Prediabetes
D. Gestational diabetes
Correct Answer: A
Rationale — Correct:
Rapid onset, weight loss, and ketones suggest severe insulin
